Manuel Pedroso, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

ME73710 Issued in FL

Practice address

2647 Hollywood Blvd
Hollywood, FL 33020-4840

Phone

(954) 923-9494

Fax

(954) 923-2887

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pedroso Pediatrics PA

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1104068113
  NPD (past) Authorized official
• Dental Care PA

  • General Practice Dentistry
  • Miami Beach, FL
  • NPI 1922682327
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1851464077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2647 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204840",
            "telephone_number": "954-923-9494",
            "fax_number": "877-286-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2647 HOLLYWOOD BLVD",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330204840",
            "telephone_number": "954-923-9494",
            "fax_number": "954-923-2887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 Alton Rd",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331403852",
            "country_code": "US",
            "telephone_number": "305-674-0654",
            "fax_number": "877-286-3853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDROSO",
        "first_name": "MANUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME73710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009092400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatrix Medical Group of Florida, Inc.
• Edyta Pedlowska, NP
• Angela Kay Pedre, RBT
• Lazaro Pedrol
• Pedroso Pediatrics PA
• Yunia Pedroso
• Pedz Haven Therapy LLC
• Peek a Boo Pediatric Care Inc.
• Shalev Peleg
• Elizabeth Peller

• Pediatric Adolescent Medicine Physician in Hollywood, FL
• Providers in Hollywood, FL by specialty
• Pediatric Adolescent Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.